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Individual

MIRINDA ANN GILLESPIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
51 PENNSYLVANIA ST # MP303, ORLANDO, FL 32806-2937
(407) 649-6876
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
132470
FL
208000000X
Pediatrics Physician
A166008
CA
208M00000X
Hospitalist Physician
ME132470
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022202700
FL
Enumeration date
12/12/2012
Last updated
03/23/2022
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